Pub Date : 2024-07-23DOI: 10.4103/mjdrdypu.mjdrdypu_904_23
N. Hariprasadh, R. Lahel, Chandan Tiwari
ABSTRACT The Indian red scorpion (Hottentotta tamulus) sting is a common clinical encounter that presents with cardiovascular complications. Patients presenting with neurological complications are rare. The present case pertains to a 26-year-old man who presented to the emergency department with complaints of pain in his right index finger following a scorpion sting and later developed seizures with right-sided hemiparesis. The relevant investigations and clinical details of this scorpion sting-induced rare case of hemiparesis are discussed herein.
{"title":"Scorpion Sting Induced Ischemic Stroke in the Young: A Rare Case Report","authors":"N. Hariprasadh, R. Lahel, Chandan Tiwari","doi":"10.4103/mjdrdypu.mjdrdypu_904_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_904_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 The Indian red scorpion (Hottentotta tamulus) sting is a common clinical encounter that presents with cardiovascular complications. Patients presenting with neurological complications are rare. The present case pertains to a 26-year-old man who presented to the emergency department with complaints of pain in his right index finger following a scorpion sting and later developed seizures with right-sided hemiparesis. The relevant investigations and clinical details of this scorpion sting-induced rare case of hemiparesis are discussed herein.","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"125 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141811483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.4103/mjdrdypu.mjdrdypu_242_23
R. Lahel, Chandan Tiwari, Hariprasadh Nagarajan
ABSTRACT Isolated cysticercosis of the sternocleidomastoid is a rare entity caused by the ingestion of eggs of Taenia solium. The case reported here is of a 24-year-old male who presented to the hospital with complaints of a firm, non-tender, isolated, progressively increasing swelling of the right side of his neck for 3 months. Diagnosis of cysticercosis was made on high-resolution ultrasound and the patient was managed medically with complete resolution. The relevant findings of the case are discussed herein.
{"title":"Rare Solitary Cysticercosis of Sternocleidomastoid Muscle Diagnosed on Ultrasound: A Case Report","authors":"R. Lahel, Chandan Tiwari, Hariprasadh Nagarajan","doi":"10.4103/mjdrdypu.mjdrdypu_242_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_242_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 Isolated cysticercosis of the sternocleidomastoid is a rare entity caused by the ingestion of eggs of Taenia solium. The case reported here is of a 24-year-old male who presented to the hospital with complaints of a firm, non-tender, isolated, progressively increasing swelling of the right side of his neck for 3 months. Diagnosis of cysticercosis was made on high-resolution ultrasound and the patient was managed medically with complete resolution. The relevant findings of the case are discussed herein.","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"87 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.4103/mjdrdypu.mjdrdypu_339_23
R. Lahel, Smriti Mathur, Amit Chail, Chandan Tiwari
ABSTRACT Cervical lymphadenopathy is a relatively common clinical presentation that can have varied causes including reactive, inflammatory, tubercular, or neoplastic etiologies. Sonography is most often the first line of investigation used in clinical practice to characterize the enlarged nodes with respect to their location, number, size, and morphological imaging characteristics and determine the differential etiological possibilities. The present study was conducted involving 434 patients who presented over a period of 3 years to radiology departments of three multispecialty hospitals for the evaluation of cervical swellings. The study aimed to establish the correlation between the ultrasound and Doppler parameters used in clinical practice and the final histological diagnosis in cases of tubercular cervical lymphadenitis. Overall, a female predisposition was observed in the proportion of patients who presented with cervical lymphadenopathy. A similar increased female percentage was also observed in cases finally detected to have tubercular pathology. The highest diagnostic indices were obtained for two ultrasound parameters of “matted nodes” and “caseous necrosis with posterior acoustic enhancement.” Although other features such as hypoechoic nodes, Doppler findings of peripheral vascularity, and high resistive index (RI)/pulsatility index (PI) values demonstrated high sensitivity, they showed poor specificity, positive predictive values, and low accuracy. In ultrasound scans for suspected cases of tubercular cervical lymphadenitis, the maximum weightage should be given to “matted nodes” and “caseous necrosis with posterior acoustic enhancement” parameters to differentiate the tubercular etiology from other potential causes. These parameters demonstrate high sensitivity, specificity, positive predictive value, and accuracy. Hence, they can be relied upon to start timely anti-tubercular treatment and follow-up with patients on a clinical-radiological basis. This can supplement waiting for suboptimal cytology reports that are difficult to arrive at, specifically in tubercular cervical lymphadenitis cases. The same applies as well to biopsy specimens that are hard to obtain from cervical nodes with associated potential grave complications.
{"title":"Correlation of Grayscale Ultrasound and Doppler Evaluation with Histopathological Diagnosis in Cases of Tubercular Cervical Lymphadenitis","authors":"R. Lahel, Smriti Mathur, Amit Chail, Chandan Tiwari","doi":"10.4103/mjdrdypu.mjdrdypu_339_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_339_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Cervical lymphadenopathy is a relatively common clinical presentation that can have varied causes including reactive, inflammatory, tubercular, or neoplastic etiologies. Sonography is most often the first line of investigation used in clinical practice to characterize the enlarged nodes with respect to their location, number, size, and morphological imaging characteristics and determine the differential etiological possibilities.\u0000 \u0000 \u0000 \u0000 The present study was conducted involving 434 patients who presented over a period of 3 years to radiology departments of three multispecialty hospitals for the evaluation of cervical swellings. The study aimed to establish the correlation between the ultrasound and Doppler parameters used in clinical practice and the final histological diagnosis in cases of tubercular cervical lymphadenitis.\u0000 \u0000 \u0000 \u0000 Overall, a female predisposition was observed in the proportion of patients who presented with cervical lymphadenopathy. A similar increased female percentage was also observed in cases finally detected to have tubercular pathology. The highest diagnostic indices were obtained for two ultrasound parameters of “matted nodes” and “caseous necrosis with posterior acoustic enhancement.” Although other features such as hypoechoic nodes, Doppler findings of peripheral vascularity, and high resistive index (RI)/pulsatility index (PI) values demonstrated high sensitivity, they showed poor specificity, positive predictive values, and low accuracy.\u0000 \u0000 \u0000 \u0000 In ultrasound scans for suspected cases of tubercular cervical lymphadenitis, the maximum weightage should be given to “matted nodes” and “caseous necrosis with posterior acoustic enhancement” parameters to differentiate the tubercular etiology from other potential causes. These parameters demonstrate high sensitivity, specificity, positive predictive value, and accuracy. Hence, they can be relied upon to start timely anti-tubercular treatment and follow-up with patients on a clinical-radiological basis. This can supplement waiting for suboptimal cytology reports that are difficult to arrive at, specifically in tubercular cervical lymphadenitis cases. The same applies as well to biopsy specimens that are hard to obtain from cervical nodes with associated potential grave complications.\u0000","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"17 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.4103/mjdrdypu.mjdrdypu_206_23
R. Lahel, Chandan Tiwari, Pradeep
ABSTRACT There are instances when elastic/thread bands are worn on the wrist, especially in infants or children in certain communities for either decorative or religious purposes. In case, it is worn for a long time, it burrows through the skin and soft tissues while going completely un-noticed, causing constriction and resulting in distal edema and loco-regional infection. The rare case discussed here is of a 3 years old female child who presented with circumferential constriction, swelling, and discharging sinuses around the right wrist for 7 months. The case was diagnosed on MRI and subsequently successfully managed surgically. The clinico-radiologic features and details of the case are discussed herein.
{"title":"A Rare Case Report of Constriction Band Syndrome at the Wrist in a Child (Dhaga Syndrome)","authors":"R. Lahel, Chandan Tiwari, Pradeep","doi":"10.4103/mjdrdypu.mjdrdypu_206_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_206_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 There are instances when elastic/thread bands are worn on the wrist, especially in infants or children in certain communities for either decorative or religious purposes. In case, it is worn for a long time, it burrows through the skin and soft tissues while going completely un-noticed, causing constriction and resulting in distal edema and loco-regional infection. The rare case discussed here is of a 3 years old female child who presented with circumferential constriction, swelling, and discharging sinuses around the right wrist for 7 months. The case was diagnosed on MRI and subsequently successfully managed surgically. The clinico-radiologic features and details of the case are discussed herein.","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"95 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT Laparoscopic cholecystectomy has now become gold standard treatment for gallstone diseases. Although few recent articles suggest that after laparoscopic cholecystectomy gall bladder (GB) retrieval from umbilical port is better, but the evidence is inconsistent. The objective of this study was to compare specimen retrieval from epigastric vs. umbilical port in terms of postoperative pain, time taken, and ease of retrieval. Total 200 patients aged 16-80 years were randomized by drawing lottery slips by a third person from a box containing 200 sealed envelopes (100 for each group). Those with acute cholecystitis, empyema, mucocele, suspected malignancy, and conversion to open and chronic analgesic users were excluded. Surgery was done by consultant surgeon under standard general anesthesia with four-port technique and GB was extracted either through epigastric or umbilical port as per draw. The difficulty in specimen retrieval was graded by operating surgeon on subjective linear scale and postoperative port site pain was assessed by resident blinded to intervention with Visual Analog Scale. Both groups were well matched regarding age, sex, body mass index, and comorbidities. Mean time taken to retrieve in epigastric group was 36.76 ± 6.26 vs. 22.48 ± 5.76 seconds in umbilical group (P < .01). We observed easy retrieval via umbilical port compared to epigastric (score 2.72 ± 1.42 vs. 6.48 ± 1.32, P. 001). Epigastric group patients had Visual Analog Scale 6.56±0.768, 5.60 ± 1.225, 4.56 ± 1.325, and 2.72 ± 1.308 vs. 4.16 ± 1.214, 2.72 ± 1.275, 1.76 ± 1.234, and. 92±0.759 at 1, 6, 12, and 24 hours in umbilical group. The P value at different timings were. 001, thus indicating less pain in umbilical group. Umbilical port is better than epigastric port in terms of time taken for GB retrieval, ease of retrieval, and postoperative pain.
{"title":"Comparative Evaluation of Gall Bladder Retrieval from Epigastric vs Umbilical Port After Laparoscopic Cholecystectomy","authors":"Amit Nehra, Surender Verma, Shubham Kochar, Umesh Yadav, Somya Godara, Rajesh Godara","doi":"10.4103/mjdrdypu.mjdrdypu_225_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_225_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Laparoscopic cholecystectomy has now become gold standard treatment for gallstone diseases. Although few recent articles suggest that after laparoscopic cholecystectomy gall bladder (GB) retrieval from umbilical port is better, but the evidence is inconsistent. The objective of this study was to compare specimen retrieval from epigastric vs. umbilical port in terms of postoperative pain, time taken, and ease of retrieval.\u0000 \u0000 \u0000 \u0000 Total 200 patients aged 16-80 years were randomized by drawing lottery slips by a third person from a box containing 200 sealed envelopes (100 for each group). Those with acute cholecystitis, empyema, mucocele, suspected malignancy, and conversion to open and chronic analgesic users were excluded. Surgery was done by consultant surgeon under standard general anesthesia with four-port technique and GB was extracted either through epigastric or umbilical port as per draw. The difficulty in specimen retrieval was graded by operating surgeon on subjective linear scale and postoperative port site pain was assessed by resident blinded to intervention with Visual Analog Scale.\u0000 \u0000 \u0000 \u0000 Both groups were well matched regarding age, sex, body mass index, and comorbidities. Mean time taken to retrieve in epigastric group was 36.76 ± 6.26 vs. 22.48 ± 5.76 seconds in umbilical group (P < .01). We observed easy retrieval via umbilical port compared to epigastric (score 2.72 ± 1.42 vs. 6.48 ± 1.32, P. 001). Epigastric group patients had Visual Analog Scale 6.56±0.768, 5.60 ± 1.225, 4.56 ± 1.325, and 2.72 ± 1.308 vs. 4.16 ± 1.214, 2.72 ± 1.275, 1.76 ± 1.234, and. 92±0.759 at 1, 6, 12, and 24 hours in umbilical group. The P value at different timings were. 001, thus indicating less pain in umbilical group.\u0000 \u0000 \u0000 \u0000 Umbilical port is better than epigastric port in terms of time taken for GB retrieval, ease of retrieval, and postoperative pain.\u0000","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"45 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.4103/mjdrdypu.mjdrdypu_109_23
R. Lahel, Chandan Tiwari
ABSTRACT A 23 yr old primigravida reported for a 1st-trimester antenatal scan at 12 weeks of gestation. Sonography revealed findings consistent with Cystic Hygroma with Hydrops fetalis. The case merits discussion to reflect upon the findings of these rare co-existing grave medical conditions in the fetus and emphasize the relevance of timely antenatal diagnosis of Cystic Hygroma with concomitant hydrops, the condition known to have a very high rate of fetal mortality. The relevant review of literature and findings of the case are discussed thence.
{"title":"A Rare Case Report of Cystic Hygroma with Hydrops Fetalis Detected during First-Trimester Antenatal Scan","authors":"R. Lahel, Chandan Tiwari","doi":"10.4103/mjdrdypu.mjdrdypu_109_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_109_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 A 23 yr old primigravida reported for a 1st-trimester antenatal scan at 12 weeks of gestation. Sonography revealed findings consistent with Cystic Hygroma with Hydrops fetalis. The case merits discussion to reflect upon the findings of these rare co-existing grave medical conditions in the fetus and emphasize the relevance of timely antenatal diagnosis of Cystic Hygroma with concomitant hydrops, the condition known to have a very high rate of fetal mortality. The relevant review of literature and findings of the case are discussed thence.","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.4103/mjdrdypu.mjdrdypu_257_23
Mansi Tyagi, Sajjan Pal, J. Yadav, S. Kalra
ABSTRACT As the only means of scoring in basketball, shooting or throwing is regarded as one of the essential skills that govern the game’s success. When it comes to improving muscle performance in a variety of sports, variable resistance training (VRT) also known as resistance band training is one of the effective training methods. To examine the impact of an eight-week variable resistance training (VRT) on performance and fitness measures in young collegiate basketball players. Thirty male collegiate basketball players in the age group of 18–30 years were included in this comparative study and randomly divided into two groups, group A and group B with 15 players in each group. Group A received VRT using resistance bands, whereas group B received training with free weights. Both groups received routine basketball training as well. Ball release speed, jump height, upper limb performance speed, and shooting accuracy were measured with radar gun, vertical jump test, plate tapping test, stationary free throw shooting test, and dynamic shooting test. For eight weeks, both groups underwent training thrice a week for 60 min each day for eight weeks. Significant differences were seen in VRT group P < 0.05. The experimental group improved in the following areas: ball release speed (up 9.13%), lower limb power (up 24.96%), speed of upper limb performance (up 8.24%), and accuracy (29.52%). Variable resistance training using resistance bands can be adapted as a regular training in basketball game along with conventional basketball drills for enhancement of skill performance variables in basketball players.
{"title":"Effectiveness of Eight-Week Variable Resistance Training on Ball Release Speed, Jump Height, Speed of Upper Limb Performance, and Accuracy in Young Collegiate Basketball Players","authors":"Mansi Tyagi, Sajjan Pal, J. Yadav, S. Kalra","doi":"10.4103/mjdrdypu.mjdrdypu_257_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_257_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 As the only means of scoring in basketball, shooting or throwing is regarded as one of the essential skills that govern the game’s success. When it comes to improving muscle performance in a variety of sports, variable resistance training (VRT) also known as resistance band training is one of the effective training methods.\u0000 \u0000 \u0000 \u0000 To examine the impact of an eight-week variable resistance training (VRT) on performance and fitness measures in young collegiate basketball players.\u0000 \u0000 \u0000 \u0000 Thirty male collegiate basketball players in the age group of 18–30 years were included in this comparative study and randomly divided into two groups, group A and group B with 15 players in each group. Group A received VRT using resistance bands, whereas group B received training with free weights. Both groups received routine basketball training as well. Ball release speed, jump height, upper limb performance speed, and shooting accuracy were measured with radar gun, vertical jump test, plate tapping test, stationary free throw shooting test, and dynamic shooting test. For eight weeks, both groups underwent training thrice a week for 60 min each day for eight weeks.\u0000 \u0000 \u0000 \u0000 Significant differences were seen in VRT group P < 0.05. The experimental group improved in the following areas: ball release speed (up 9.13%), lower limb power (up 24.96%), speed of upper limb performance (up 8.24%), and accuracy (29.52%).\u0000 \u0000 \u0000 \u0000 Variable resistance training using resistance bands can be adapted as a regular training in basketball game along with conventional basketball drills for enhancement of skill performance variables in basketball players.\u0000","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"119 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.4103/mjdrdypu.mjdrdypu_794_23
Shilpa Kore, S. T. Vazhakalayil, Fathima Fasil
ABSTRACT To analyze the effectiveness of dexmedetomidine and fentanyl pre-medication, followed by infusion in modulating hemodynamic and neuro-endocrine responses to laryngoscopy and pneumoperitoneum during laparoscopic surgery. Forty adult patients were randomized into two groups. Before induction, group dexmedetomidine (group D) were given dexmedetomidine at 0.5 μgm/kg IV as loading over 10 min and infusion at the rate of 0.2 mcg/kg/hour during the surgical procedure. Group fentanyl (group F) were given 0.5 mcg/kg as loading over 10 min and infusion at the rate of 0.2 mcg/kg/hour during the surgical procedure. Hemodynamic parameters and blood glucose levels were pre-operatively monitored. No significant differences were observed in the demographic profiles. There was a discernible difference in the heart rate compared to the pre-operative values in both groups. The systolic blood pressure was significantly lower in group D than in group F. There were no significant changes in the blood glucose levels during the intra-operative period, and the blood glucose levels remained low after extubation in group D (P = 0.0001). Dexmedetomidine causes greater attrition of the hemodynamic response to intubation and pneumoperitoneum during the peri-operative period and modulates the neuro-endocrine stress response, resulting in better hemodynamic stability.
{"title":"Comparison of Opioid Versus Non-opioid-based Anesthesia Techniques for Hemodynamic and Neuro-endocrine Responses in Laparoscopic Surgeries","authors":"Shilpa Kore, S. T. Vazhakalayil, Fathima Fasil","doi":"10.4103/mjdrdypu.mjdrdypu_794_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_794_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 To analyze the effectiveness of dexmedetomidine and fentanyl pre-medication, followed by infusion in modulating hemodynamic and neuro-endocrine responses to laryngoscopy and pneumoperitoneum during laparoscopic surgery.\u0000 \u0000 \u0000 \u0000 Forty adult patients were randomized into two groups. Before induction, group dexmedetomidine (group D) were given dexmedetomidine at 0.5 μgm/kg IV as loading over 10 min and infusion at the rate of 0.2 mcg/kg/hour during the surgical procedure. Group fentanyl (group F) were given 0.5 mcg/kg as loading over 10 min and infusion at the rate of 0.2 mcg/kg/hour during the surgical procedure. Hemodynamic parameters and blood glucose levels were pre-operatively monitored.\u0000 \u0000 \u0000 \u0000 No significant differences were observed in the demographic profiles. There was a discernible difference in the heart rate compared to the pre-operative values in both groups. The systolic blood pressure was significantly lower in group D than in group F. There were no significant changes in the blood glucose levels during the intra-operative period, and the blood glucose levels remained low after extubation in group D (P = 0.0001).\u0000 \u0000 \u0000 \u0000 Dexmedetomidine causes greater attrition of the hemodynamic response to intubation and pneumoperitoneum during the peri-operative period and modulates the neuro-endocrine stress response, resulting in better hemodynamic stability.\u0000","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"62 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT Pituitary apoplexy is a rare endocrine emergency that is occasionally life-threatening, most often involving pituitary macroadenomas. Most pituitary macroadenomas are nonsecretory and are diagnosed in the late stages. They remain undiagnosed until they cause compression of the surrounding vital structures and lead to subsequent symptoms. The clinical feature depends on the size of the tumor and the direction of the spread. There are two approaches for surgery. The less invasive endoscopic transnasal transsphenoidal approach is favored more than the transcranial approach. 46-year-old female patient presented to the outpatient department (OPD) with complaints of headache and drooping of the right eyelid for 1.5 months. On neurological examination, right severe ptosis was present and extraocular movements of the right eye are restricted for the muscles supplied by the third nerve. Pupils were reactive to light. On perimetry, the left eye showed temporal hemianopia. Right eye perimetry was not done due to ptosis. MRI Brain gave differential diagnosis as pituitary macroadenoma with hemorrhage or necrosis and pituitary apoplexy without macroadenoma. Endoscopic transnasal transsphenoidal excision of the tumor under general anesthesia was performed. MRI brain is the preferred imaging for cases with high suspicion of pituitary apoplexy. Endoscopic transnasal transsphenoidal excision of the tumor is an excellent choice for surgical resection of pituitary adenomas, with improved rates of complete tumor removal and reduced incidence of complication.
{"title":"Endoscopic Transsphenoidal Approach in Pituitary Apoplexy – A Case Report","authors":"Vinod Shinde, Mayur Ingale, Anvitha Suresh, Deepak Ranade","doi":"10.4103/mjdrdypu.mjdrdypu_403_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_403_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Pituitary apoplexy is a rare endocrine emergency that is occasionally life-threatening, most often involving pituitary macroadenomas. Most pituitary macroadenomas are nonsecretory and are diagnosed in the late stages. They remain undiagnosed until they cause compression of the surrounding vital structures and lead to subsequent symptoms. The clinical feature depends on the size of the tumor and the direction of the spread. There are two approaches for surgery. The less invasive endoscopic transnasal transsphenoidal approach is favored more than the transcranial approach.\u0000 \u0000 \u0000 \u0000 46-year-old female patient presented to the outpatient department (OPD) with complaints of headache and drooping of the right eyelid for 1.5 months. On neurological examination, right severe ptosis was present and extraocular movements of the right eye are restricted for the muscles supplied by the third nerve. Pupils were reactive to light. On perimetry, the left eye showed temporal hemianopia. Right eye perimetry was not done due to ptosis. MRI Brain gave differential diagnosis as pituitary macroadenoma with hemorrhage or necrosis and pituitary apoplexy without macroadenoma. Endoscopic transnasal transsphenoidal excision of the tumor under general anesthesia was performed.\u0000 \u0000 \u0000 \u0000 MRI brain is the preferred imaging for cases with high suspicion of pituitary apoplexy. Endoscopic transnasal transsphenoidal excision of the tumor is an excellent choice for surgical resection of pituitary adenomas, with improved rates of complete tumor removal and reduced incidence of complication.\u0000","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.4103/mjdrdypu.mjdrdypu_80_23
Divya Sree Akuthota, Chintakunta V. Subbarayudu, Sowmya Pallavi Rapuri, Gopi Krishna Bellamkonda, Ravi Gottumukkala
ABSTRACT Even though the survival of people living with HIV/AIDS (PLWHA) has improved by ART, their lifestyles and quality of life are affected by several factors like family and community support, and their socio-economic status. Hence, this study was undertaken to estimate the quality of life of HIV/AIDS patients based on the World Health Organization Quality Of Life-Human Immunodeficiency Virus Brief (WHOQOL-HIV BREF) questionnaire and to assess the association of quality of life with socio-demographic variables. A cross-sectional study was conducted from April 2019 to December 2020 in a sample of 220 HIV/AIDS patients of age more than 18 years, taking treatment at ART center, Tertiary Care Hospital in Tirupati. The data were collected using a standardized instrument (WHOQOL-HIV BREF). Socio-demographic details of the subjects were also obtained. Data were analyzed using Epi info software 7.2.2.6 version. The overall mean QOL score is 59.3 ± 10.3. The highest mean QOL observed in the physical domain and the most affected domain is the social relationship’s domain. Lower levels of QOL were seen in females, residing in rural areas, illiterates, separated/divorced, who does not reveal their HIV status to their family members, who does not have family support, and these are found to be significantly associated with QOL (P < 0.05). The most affected domain is social relationship’s domain. Age, residence, educational status, marital status, knowledge of HIV status to family members, and their family support were found to be significantly associated with QOL among PLWHA.
ABSTRACT 尽管通过抗逆转录病毒疗法，艾滋病病毒感染者/艾滋病患者（PLWHA）的生存率有所提高，但他们的生活方式和生活质量仍受到家庭和社区支持以及社会经济状况等多种因素的影响。因此，本研究根据世界卫生组织生活质量--人类免疫缺陷病毒简明调查表（WHOQOL-HIV BREF）对艾滋病患者的生活质量进行了评估，并评估了生活质量与社会人口变量的关系。 这项横断面研究于 2019 年 4 月至 2020 年 12 月在蒂鲁帕蒂三级医院抗逆转录病毒疗法中心对 220 名年龄超过 18 岁、正在接受治疗的艾滋病毒/艾滋病患者进行了抽样调查。数据使用标准化工具（WHOQOL-HIV BREF）收集。同时还获得了受试者的社会人口学详细信息。数据使用 Epi info 软件 7.2.2.6 版本进行分析。 总体平均 QOL 得分为 59.3 ± 10.3。在身体领域观察到的平均 QOL 值最高，受影响最大的领域是社会关系领域。女性、居住在农村地区、文盲、分居/离婚、不向家人透露自己的 HIV 感染状况、没有家庭支持的人的 QOL 水平较低，这些因素与 QOL 有显著相关性（P < 0.05）。 受影响最大的领域是社会关系领域。研究发现，年龄、居住地、教育程度、婚姻状况、对家庭成员艾滋病状况的了解程度以及家人的支持与 PLWHA 的 QOL 有显著相关性。
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